Search Results (575)

Background/Objectives: Older adults often face nutrition challenges due to mobility issues, chronic conditions, and limited access to adequate nutrition. Digital and technology-based interventions, including those with nutrition education, nutrition counseling and Medically Tailored Meals [MTMs], can help address these barriers. However, the extent and characteristics of such programs in the United States remain unclear. This scoping review aimed to map the existing evidence on digital and technology-based (“digi-tech”) nutrition interventions for older adults in the United States, with particular attention to the presence, characteristics, and gaps related to MTMs. Methods: This scoping review followed the PRISMA-ScR framework to map existing evidence on technology-enabled nutrition care interventions for older adults aged ≥ 60 years in the United States. Systematic searches were conducted across multiple databases, yielding 18,177 records. Following title and abstract screening, full-text review, and eligibility assessment, 16 intervention studies were included. Study designs comprised randomized controlled trials, quasi-experimental and non-randomized studies, mixed-methods feasibility studies, pilot studies, and one retrospective longitudinal cohort study. Data were extracted on study design, population characteristics, intervention components, technology modalities, outcomes, feasibility, acceptability, and reported barriers. Results: Interventions varied in duration [8 weeks to ≥12 months] and content. Foci ranged from remote nutrition education and mobile app-based tracking to multicomponent interventions integrating exercise, nutrition counseling, health literacy, and meal delivery. Telehealth was the most commonly used technology modality, followed by mobile health applications, wearable devices, and online educational platforms. Most interventions reported high feasibility and acceptability, with improvements in diet quality, adherence to healthy eating patterns, clinical measures such as HbA1c and blood pressure, and functional performance. Common implementation barriers included declining technology use over time, digi-tech literacy, and access to devices or the internet. Notably, no studies evaluated a digi-tech-based MTMs intervention exclusively for older adults in the U.S. Conclusions: Digital and technology-based nutrition interventions show promise for improving dietary and health outcomes in older adults, but there is insufficient empirical evidence. Future research might develop and evaluate hybrid digi-tech intervention models that leverage the potential of digi-tech tools while addressing barriers to technology adoption among older adults. Full article

Background/Objectives: Patient-level factors strongly influence antimicrobial resistance (AMR) through the pressure applied to healthcare professionals to prescribe antibiotics even for self-limiting viral infections, enhanced by knowledge and attitude concerns. This includes Africa, with high levels of AMR. However, validated measurement tools for African primary healthcare (PHC) are scarce. This study evaluated the reliability, structural validity, and interpretability of the Community Antimicrobial Use Scale (CAMUS) in South Africa. Methods: A cross-sectional survey was conducted with 1283 adults across 25 diverse public PHC facilities across two provinces. The 30-item theory-based tool underwent exploratory and confirmatory factor analysis (EFA/CFA), reliability, and validity testing. Results: EFA identified a coherent five-factor structure: (F1) Understanding antibiotics; (F2) Social and behavioural norms; (F3) Non-prescribed use; (F4) Understanding of AMR; and (F5) Attitudes. Internal consistency was strongest for knowledge and misuse domains (alpha approximation 0.80). Test–retest reliability was good-to-excellent (ICC: 0.72–0.89). CFA confirmed acceptable composite reliability (CR ≥ 0.63). Although average variance extracted (AVE) was low for broader behavioural constructs, indicating conceptual breadth, it was high for AMR knowledge (0.737). Construct validity was supported by positive correlations with health literacy (r = 0.48) and appropriate use intentions (r = 0.42). Measurement error metrics (SEM = 1.59; SDC = 4.40) indicated good precision for group-level comparisons. Conclusions: CAMUS demonstrated a theoretically grounded structure with robust performance in knowledge and misuse domains. While social and attitudinal domains require refinement, we believe the tool is psychometrically suitable for group-level antimicrobial use surveillance and programme evaluation in South African PHC settings and wider to help with targeting future educational programmes among patients. Full article

Digital inclusion has become an essential component in ensuring the autonomy, social participation, and well-being of older adults. However, their learning of digital skills depends to a large extent on the quality of support provided by the facilitator, whose age, training, and experience directly influence teaching processes and how older adults relate to technology. This study compares the digital competences, and ICT skills of 107 facilitators of digital literacy programs, classified into three groups: peer educators (PEERS), young students without gerontological training (YOS), and young gerontology specialists (YGS). A quantitative design was used. Statistical analyses included non-parametric tests (Kruskal–Wallis, Mann–Whitney, Kendall’s Tau) and parametric tests (ANOVA, t-tests), to examine associations between socio-demographic variables, the level of digital competence, and ICT skills for teachers (technological and pedagogical). The results show clear differences between profiles. YOS achieved the highest scores in digital competence, especially in problem-solving and tool handling. The YGS achieved a balanced profile, combining competent levels of digital skills with pedagogical strengths linked to their gerontological training. In contrast, PEERS recorded the lowest levels of digital competence, particularly in security and information management; nevertheless, their role remains relevant for fostering trust and closeness in training processes among people of the same age. It was also found that educational level is positively associated with digital competence in all three profiles, while age showed a negative relationship only among PEERS. The findings highlight the importance of creating targeted training courses focusing on digital, technological, and pedagogical skills to ensure effective, tailored teaching methods for older adults. Full article

Background/Objectives: Even with solid proof of its benefits for cardiovascular health and metabolism, adherence to the Mediterranean Diet (MD) in Spain has noticeably declined in recent years. The socioeconomic changes occurring in recent decades have prompted shifts in cooking habits and in how food is socially experienced, particularly among children and adolescents. The MD is more than just food: it is a cultural tradition and a lifestyle, rich in food and cooking skills, and food wisdom passed down over generations. When these practices fade, it affects both health and the environment, making them vital components in strengthening support for food knowledge, cooking abilities, and a healthier lifestyle. Considering these shifting dietary patterns and the growing need for targeted educational strategies, the present study aimed to investigate the association between cooking skills, MD-related health literacy, and adherence to the Mediterranean Diet across different developmental stages: childhood, adolescence, and adulthood in a sample of the Spanish population. Additionally, a secondary objective was to identify potential critical windows for intervention based on the strength of these associations. Methods: This cross-sectional study included 832 Spanish participants grouped by age: children and early adolescents (n = 408), older adolescents (n = 136), and adults (n = 288). Cooking skills were assessed using CooC11 for children and FCSk for older groups. Adults also completed Lit_MEDiet to assess MD-related health literacy. Adherence was measured with KIDMED (children/adolescents) and MEDAS (adults). Spearman correlations and standardized linear regressions were used. All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results: In children, no significant association was found between cooking skills (CooC11) and KIDMED scores (β = 0.008; p = 0.875). Among adolescents, a strong positive association emerged between FCSk and KIDMED (β = 0.313; p < 0.001; ρ = 0.371), indicating a large, standardized effect and suggesting that this stage is particularly sensitive to food skills. In adults (18+), both food and cooking skills (FCSk) (β = 0.189; p = 0.001) and MD-related health literacy (Lit_MEDiet) (β = 0.187; p = 0.004) were moderately associated with MEDAS scores. Conclusions: These findings suggest that mid-adolescence could represent a favourable developmental window where food skills may hold potential to influence positive dietary behaviours. Regarding adults, the results indicate that combining practical and educational components appears to beneficial for dietary quality. Overall, this study supports the relevance of age-tailored public health strategies to potentially enhance long-term adherence to the Mediterranean Diet. Full article

The global demand for argan oil has grown considerably in recent years, creating economic opportunities while raising concerns about ecosystem degradation and the sustainability of production systems. To support long-term viability, several initiatives have promoted environmentally friendly practices and fair value-chain models. However, the effective market integration of these initiatives depends on understanding consumer behavior and preferences toward sustainable products. This study aims to identify the determinants influencing consumers’ purchase intention for sustainable argan oil using an extended framework of the Theory of Planned Behavior (TPB). A structural equation modeling approach was applied to analyze responses from adult consumers with a minimum education level of secondary education. The results show that consumer attitude, perceived behavioral control, and willingness to pay have significant positive effects on purchase intention, while ecological literacy exerts an indirect influence through attitude, social norms, perceived behavioral control, and willingness to pay. In contrast, ecological literacy has no significant direct impact. These findings improve the understanding of behavioral mechanisms underlying green product consumption and offer insights into designing marketing strategies that align with sustainability values and promote responsible consumer choices. Full article

The development of generative artificial intelligence tools, including large language models, opens new opportunities for adult education while simultaneously posing the risk of deepening inequalities resulting from differences in digital competences and individual dispositions. The aim of this article is to examine how digital skills (DS) and personal innovativeness (PI) shape differentiated and advanced use of ChatGPT (UC) among adult learners in Poland, with particular attention to the moderating role of gender. The study was conducted using the CAWI method on a nationwide sample of 757 adult ChatGPT users engaged in upgrading their qualifications. Validated scales of DS, PI, and UC were applied, along with confirmatory factor analysis (CFA) and structural equation modeling (SEM) using the WLSMV estimator, as well as multigroup SEM for women and men. The results confirm that both digital skills (β ≈ 0.46) and personal innovativeness (β ≈ 0.37) significantly and positively predict advanced use of ChatGPT, jointly explaining approximately 41% of the variance in UC, with stronger effects observed among men than women. Attention is therefore drawn to the need to incorporate a gender perspective in further research on the use of GenAI in adult education The findings point to a stratification of GenAI use in adult education and underscore the need to incorporate critical digital competences and AI literacy into sustainable education policies in order to limit the reproduction of existing inequalities. Full article

Background/Objectives: The increasing availability of online health information underscores the importance of digital resources and internet use, especially for older adults. Despite the benefits, utilization of Welcome to Medicare (WTM) and Annual Wellness Visits (AWV) remains suboptimal, particularly for those with diabetes. This study examined the relationship between internet use and WTM/AWV utilization among Medicare beneficiaries with diabetes. Methods: The 2021 Medicare Current Beneficiary Survey was analyzed, which is a nationally representative survey of Medicare beneficiaries aged ≥65 years with self-reported type 2 diabetes (n = 1444). The binary dependent variable was self-reported WTM/AWV utilization. The 3 binary independent variables were whether beneficiaries used the internet to (1) look up health information; (2) schedule an appointment with healthcare provider; and (3) communicate with healthcare provider. A survey-weighted logistic regression model was used to examine their associations, adjusted for socio-demographics and comorbidities. Results: Of study beneficiaries, 57.5% reported WTM/AWV utilization. Among WTM/AWV users and non-users, 56.1% and 42.5%, respectively, looked up health information online. Additionally, among WTM/AWV users and non-users, 31.6% and 26.1%, respectively, scheduled appointments online, and 39.8% and 34.3%, respectively, communicated with providers online. Adjusted analysis found that looking up health information online was associated with higher odds of WTM/AWV utilization (OR: 1.76, 95% CI: 1.36–2.28), while the other internet use behaviors were not statistically significant. Conclusions: Approximately 40% of study beneficiaries did not report using WTM/AWV. Improving internet use for health information and digital literacy among at-risk Medicare beneficiaries with diabetes may have a positive influence on WTM/AWV utilization and may support broader use of digital tools in diabetes care. Full article

The underrepresentation of women in science, technology, engineering, and mathematics (STEM) fields has been a longstanding issue. Traditionally, research on sex differences in cognitive abilities has focused on mean scores, which are often trivial and do not appear to explain sex disparities in STEM participation. Recently, intraindividual strengths have been proposed as a more relevant factor; they reflect an individual’s relative advantage in one skill (e.g., literacy) compared with a set of related skills (literacy, numeracy, and problem-solving). Previous studies have primarily examined younger cohorts, and intraindividual strengths remain unexplored across the lifespan. In this study, we employed data from the second cycle of the Programme for the International Assessment of Adult Competencies (PIAAC) including 157,525 individuals from 30 countries to assess sex differences in literacy, numeracy, and problem-solving as intraindividual strengths across five age groups (16–24, 25–34, 35–44, 45–54, and 55+ years). Consistent with previous research, women outperformed men in literacy, while men outperformed women in numeracy. These patterns were observed universally across countries and age groups. In contrast, no sex differences were observed in problem-solving. Future research should move beyond mean scores to focus on intraindividual strengths, as they may be more relevant for understanding sex disparities in STEM. Full article

As China’s population ages and the sustainability of the public pension system is at risk, personal savings become crucial. As such, the quality of financial planning for retirement (FPR) has been recognized as a key to safeguarding financial well-being during retirement. This study examines the relationships of two predictors (future time perspective and risk tolerance) and a mediator (subjective financial literacy) in shaping financial planning for retirement, with particular attention to potential gender differences. Using survey data retrieved from respondents aged between 23 and 60 years old, overall sample and gender-based multigroup analysis were used to examine whether gender moderates these relationships. The results reveal that both future time perspective and subjective financial literacy positively influence financial planning for retirement across all gender groups. Notably, we found no significant gender gap in retirement planning behavior. Subjective financial literacy serves as a significant mediator linking both future time perspective and risk tolerance to retirement planning, though the indirect effect of risk tolerance through financial literacy differs significantly between genders. Academically, theoretical propositions related to retirement planning can be accounted for by both genders. Practically, standardized policy can be tailored to address retirement issues across genders. The study emphasizes that financial planning for retirement in China shows no gender gap, and this provides meaningful guidance to policymakers and financial institutions to develop measures to encourage individuals to take financial actions in retirement planning. Finally, the combined interpretation of a strong effect of subjective financial literacy and an insignificant effect of risk tolerance raises concern that adult income earners in China are affected by financial literacy bias when practicing financial retirement planning. Full article

Objectives: Lifestyle behaviors such as physical activity, cognitive engagement, social interaction, diet, sleep, and vascular risk management are increasingly recognized as contributors to cognitive aging and dementia risk. Although many middle-aged and older adults express interest in maintaining brain health, less is known about their beliefs about brain-healthy behaviors or their preferences for receiving multicomponent brain health interventions. This study examined adults’ ratings of the usefulness of a wide range of lifestyle activities for brain health and their preferred formats for receiving support. Methods: A 60-item online survey was administered to compensated volunteers aged 40 years and older through a commercial provider. The questionnaire assessed perceived usefulness of lifestyle-based brain health activities and preferred intervention delivery formats. The analytic sample included 761 respondents. Descriptive statistics were computed for all ratings and differences by age group and gender were tested using MANOVA with post hoc comparisons adjusted for multiple testing. Results: Participants endorsed many lifestyle activities as helpful for brain health. Mentally stimulating activities, good sleep, stress management, and creative activities received the highest ratings, whereas strength training, meditation, language learning, and computer-based cognitive training were rated lower. Aerobic exercise and mentally stimulating activities were most frequently selected as the single most important activity. Significant effects of age, gender, and their interaction were observed, with younger men and older women generally rating activities more favorably. With respect to desire for services, over half of participants preferred receiving a cognitive assessment, and many favored online education or app-based tools. Conclusions: Middle-aged and older adults recognize a wide range of lifestyle factors as potentially beneficial for brain health and express strong interest in structured support, particularly assessments and digital resources. These findings can inform the design of flexible, multicomponent brain health interventions aligned with adults’ preferences and priorities. Full article

This study empirically analyzed changes in the representation of older adults in Korean digital media from 2020 to 2024. As Korea enters a super-aged society, social perceptions of aging and older adults are rapidly evolving through digital platforms. This study aimed to identify how public discourse about older adults has shifted in emotional tone and thematic structure within online media environments. Approximately 200,000 text data points were collected from news and YouTube comments containing keywords related to older adults. Text mining techniques—including Latent Dirichlet Allocation (LDA) topic modeling, sentiment analysis, and time-series analysis—were applied to examine annual trends and emotional transitions. The findings revealed a clear shift in thematic emphasis from “health,” “care,” and “vulnerability” toward “participation,” “self-management,” and “digital activity.” Negative sentiments decreased (from 58.3% in 2020 to 37.8% in 2024), while positive sentiments increased (from 22.5% to 42.7%). These results indicate that the image of older adults in digital discourse has transformed from that of passive care recipients to active and independent participants in society. The study supports the ongoing policy debate in Korea on redefining the age threshold for “older adults” from 65 to 70 years, emphasizing capability over chronological age. Digital media play a critical role in shaping these changing perceptions, highlighting the need for intergenerational media literacy education and policy interventions that promote inclusive and age-positive communication. Full article

Background/Objectives: Within public health and preventive nutrition, food labeling plays a critical role in supporting healthier dietary behaviors. This study aimed to evaluate the behaviors, perceptions, and nutritional literacy of young adults from Iași, Romania, regarding simple carbohydrates (SCHO) consumption and food label-reading habits. Materials and Methods: A cross-sectional survey was conducted between May–June 2023 using 20-item Likert-scale questionnaire completed by 150 participants aged 18–30 years. Statistical analysis included descriptive metrics, Chi-square tests, and Pearson’s correlation, with significance set at p ≤ 0.05. Results: The cohort consisted of 72% females (N = 108) and 28% males (N = 42), with 42.7% (N = 64) holding university degrees. Although 22% (N = 33) considered SCHO consumption highly important, only 13.3% (N = 20) frequently read nutrition labels (p ≤ 0.05). Dietary patterns showed that 27.3% primarily consumed sweets, while others combined sweets with carbonated beverages, dairy products, or whole grains; overall, 44% (N = 66) reported frequent sweet consumption. Label reading was highest for sweets (40.7%), lower for dairy products (19.3%) and soft drinks (9.3%). Additionally, 30.7% (N = 46) checked only expiration dates, whereas just 11.3% (N = 17) reviewed nutritional content. Trust in label accuracy was low: 48% (N = 72) expressed neutrality and 14% (N = 21) disagreed. Although 77.3% (N = 116) recognized the link between sugar intake and dental caries, only 23.3% (N = 35) felt well informed about oral health risks. Taste dominated food selection (68.7%), while nutritional value was cited by 16.7% (N = 25). Conclusions: Young adults from Iași demonstrated notable gaps in nutritional literacy and suboptimal dietary behaviors, emphasizing the need for structured educational strategies to improve preventive practices relevant to systemic and oral health. Full article

Background/Objectives: Interventions promoting the Mediterranean Diet (MedDiet) and healthy lifestyle behaviours are effective and cost-efficient in preventing non-communicable diseases (NCDs), yet sustaining adherence remains challenging. This study explored perceived health impacts on, barriers to, and facilitators of adherence among older Spanish adults participating in a randomised clinical trial (RCT) based on the MedDiet and lifestyle interventions. Methods: A qualitative study was conducted with 17 Spanish participants (aged 60–81 years) with overweight/obesity and metabolic syndrome (MetS). In-depth, semi-structured interviews were audio-recorded, transcribed verbatim, and analysed through inductive thematic analysis with a gender-sensitive approach. Results: Participants identified several facilitators, including perceived improvements in vitality, psychological well-being, and physical performance, alongside enhanced nutritional literacy and confidence in orchestrating daily dietary practices. Women emphasised empowerment, autonomy, and the satisfaction of promoting family health. Main barriers included low motivation, disease burden, mobility restrictions, and limited partner support, with women particularly highlighting emotional and relational factors. A continuous, trust-based relationship with the research team acted as a strong external facilitator supporting long-term commitment. Conclusions: Perceived health gains, self-efficacy, social engagement, and research team support facilitated adherence, while low motivation, illness burden, and limited partner involvement hindered it. These findings highlight the importance of gender- and context-sensitive strategies to optimise adherence and the long-term effectiveness of Mediterranean lifestyle interventions. Full article

Cancer is the second leading cause of death in the U.S., with 612,000 deaths estimated in 2023. Cancer screening (CS) reduces mortality through early detection, but the impact of chronic conditions like adult asthma (AA) on screening is less understood. This study explores the association between AA and uptake of prostate, breast, cervical, and colorectal CS using BRFSS 2016, 2018, 2020 and 2022 data. Weighted and adjusted multivariable logistic regression assessed the association between AA and CS across sex and age-based subgroups with significant effect modification testing and subsequent subgroup analyses. Results showed significantly higher CS adherence among individuals with AA across all four CS sites compared to counterparts without asthma (CCWA). Males (55–69 years old (YO)) with AA had 15% significantly higher weighted and adjusted odds (WAO) of prostate CS (95% CI: 1.04–1.27). Women (50–74 YO) with AA had 16% significantly higher WAO of breast CS (95% CI: 1.01–1.32), with non-depressed, heavy-drinking women showing 300% significantly higher WAO (95% CI: 2.20–7.22) of breast CS. Women (21–65 YO) with AA had 9% significantly higher WAO of cervical CS (95% CI: 1.02–1.17), with education significantly modifying the association (WAOR for college-educated women = 1.23, 95% CI: 1.11–1.36). When CCWA, colorectal CS showed significantly higher odds of 36% for men aged 50–75 (95% CI: 1.24–1.49) and 24% for women aged 50–75 (95% CI: 1.15–1.33). This is the first national study to examine the association between AA and uptake of prostate, female breast, cervical, and colorectal CS over four years. Individuals with AA had significantly greater odds of CS adherence than CCWA. Effect modification by heavy drinking and education suggests the need for targeted outreach and low-literacy interventions. Full article

Rural and unincorporated communities (UCs) experience persistent health disparities driven by limited healthcare infrastructure, geographic isolation, and socioeconomic inequities. Health literacy (HL), the ability to obtain, understand, and use health information, is a critical yet underexplored determinant of health outcomes in these settings. This study examined HL and barriers to healthcare and health information access among low-income adults living with chronic conditions in nine rural UCs in Southern California. A descriptive cross-sectional survey was administered in English or Spanish to 222 respondents during community food distribution events. The questionnaire included demographics, self-reported health status, chronic disease history, perceived access to care and health information, trust in information sources and HL assessment using the Newest Vital Sign (NVS). Over four-fifths (82.7%) of respondents demonstrated limited or possibly limited HL. Although Spanish-speaking respondents scored significantly lower than English speakers on the NVS, language was not a significant predictor of HL after adjusting for age, gender, education and Hispanic origin. Lower education and older age were associated with reduced HL. One in four respondents reported barriers to healthcare access, primarily due to distance and appointment availability. Over half of the respondents reported difficulty accessing or understanding health information, regardless of HL or demographic characteristics. Doctors were the most trusted source of health information, while trust in government and religious organizations was lowest. Findings reveal pervasive low HL and broad challenges accessing care and health information across rural UCs, highlighting the structural and educational inequities underlying these disparities. Addressing these gaps requires community-driven, bilingual, and culturally resonant strategies that build trust, enhance communication, and strengthen health system accessibility for residents of unincorporated rural regions. Full article